Koh, Kwang Kon; Quon, Michael J; Han, Seung Hwan; Chung, Wook-Jin; Ahn, Jeong Yeal; Seo, Yiel-Hea; Choi, In Suck; Shin, Eak Kyun
Journal of the American College of Cardiology
2005May ; 45 ( 10 ) :1649-53.
PMID : 15893182
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Koh, Kwang Kon -
Quon, Michael J -
Han, Seung Hwan -
Chung, Wook-Jin -
Ahn, Jeong Yeal -
Seo, Yiel-Hea -
Choi, In Suck -
Shin, Eak Kyun -
ABSTRACT
OBJECTIVES: We compared vascular and metabolic responses (and adverse responses) to statin and fibrate therapies alone or in combination in patients with combined hyperlipidemia. BACKGROUND: The mechanisms of action for statins and fibrates are distinct.
METHODS: Fifty-six patients were given atorvastatin 10 mg and placebo, atorvastatin 10 mg and fenofibrate 200 mg, or fenofibrate 200 mg and placebo daily during each two-month treatment period of a randomized, double-blind, placebo-controlled crossover trial with two washout periods of two months' each.
RESULTS: Lipoproteins were changed to a greater extent with combined therapy when compared with atorvastatin or fenofibrate alone. Flow-mediated dilator response to hyperemia and plasma high-sensitivity C-reactive protein and fibrinogen levels were changed to a greater extent with combined therapy when compared with atorvastatin or fenofibrate alone (p < 0.001, p = 0.182, and p = 0.015 by analysis of variance [ANOVA], respectively). The effects of combined therapy or fenofibrate alone on plasma adiponectin levels and insulin sensitivity (determined by the Quantitative Insulin-Sensitivity Check Index [QUICKI]) were significantly greater than those of atorvastatin alone (p = 0.022 for adiponectin and p = 0.049 for QUICKI by ANOVA). No patients were withdrawn from the study as the result of serious adverse effects.
CONCLUSIONS: Combination therapy is safe and has beneficial additive effects on endothelial function in patients with combined hyperlipidemia.
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MESH
Arteriosclerosis/blood/drug therapy/ultrasonography, Atorvastatin Calcium, Brachial Artery/drug effects/ultrasonography, Cross-Over Studies, Double-Blind Method, Drug Therapy, Combination, Female, Fenofibrate/*administration & dosage/adverse effects, Follow-Up Studies, Heptanoic Acids/*administration & dosage/adverse effects, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage/adverse, Hyperlipidemia, Familial Combined/blood/*drug therapy/ultrasonography, Hypolipidemic Agents/*administration & dosage/adverse effects, Lipids/*blood, Male, Middle Aged, Myocardial Ischemia/blood/drug therapy/ultrasonography, Pyrroles/*administration & dosage/adverse effects, Treatment Outcome
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